Cystic fibrosis (CF) patients have an alteration in fatty acid (FA) metabolism, associated with increased omega-6 and low omega-3 FA. Previous studies on supplementation with omega-3 FA in CF had contradictory results, and to date there is no evidence to recommend routine use of omega-3 supplements in CF patients. We hypothesized that long-term supplementation with docosahexaenoic acid (DHA) will have beneficial effects in these patients, by reducing pulmonary, systemic and intestinal inflammation.
This was a randomized, double-blind, parallel, placebo-controlled trial. CF patients (age >2 months) were randomized to receive a seaweed DHA oil solution (50 mg/Kg/day) or matching placebo for 48 weeks. Primary outcomes were pulmonary (interleukin [IL]-8), systemic (IL-8) and intestinal (calprotectin) inflammatory biomarkers. Secondary outcomes included other pulmonary (IL-1β, IL-6, neutrophil elastase, lactate and calprotectin) and systemic (serum-IL-1β, IL-6) inflammatory biomarkers, as well as clinical outcomes (FEV, pulmonary exacerbations, antibiotic use, nutritional status and quality of life).
Ninety six CF patients, 44 female, age 14.6±11.9 years (48 DHA and 48 placebo) were included. At trial completion, there were no differences in all primary outcomes [serum-IL-8 (p=0.909), respiratory-IL-8 (p=0.384) or fecal calprotectin (p=0.948)], all secondary inflammatory biomarkers, or in any of the clinical outcomes evaluated. There were few adverse events, with similar incidence in both study groups.
In this study, long-term DHA supplementation in CF patients was safe, but did not offer any benefit on inflammatory biomarkers, or in clinical outcomes compared with placebo. (NCT01783613).
Copyright © 2020 Elsevier Ltd. All rights reserved.
About The Expert
Alejandro López-Neyra
Lucrecia Suárez
Marta Muñoz
Ana de Blas
Marta Ruiz de Valbuena
María Garriga
Joaquim Calvo
Carmen Ribes
Rosa Girón Moreno
Luis Máiz
David González
Carlos Bousoño
Javier Manzanares
Óscar Pastor
Javier Martínez-Botas
Rosa Del Campo
Rafael Cantón
Garbiñe Roy
Miriam Menacho
David Arroyo
Javier Zamora
Joan B Soriano
Adelaida Lamas
References
PubMed